Environment and health issues are a top concern: interview with Austėja Sakalauskaitė, youth activist

Austėja Sakalauskaitė, a medical student from Lithuania, brings a unique blend of health-care knowledge and communication skills to her youth activism. She found her purpose in the Lithuanian Medical Students' Association and the International Youth Health Organization, where she became more involved in impactful information and advocacy campaigns for her peers.

Discovering low vaccination rates for tick-borne encephalitis in her home country sparked her engagement in health policy dialogue. But it is climate change and its impact on health that eventually became Austėja's primary focus, leading her to join WHO/Europe's Youth4Health network. There, she continues campaigning for a healthier, more sustainable future alongside fellow youth activists.

Ahead of International Youth Day, we talked with Austėja about the urgency of environment and health issues, her drive to improve public health, and the role of youth organizations and networks in global climate and health negotiations.

WHO/Europe: Why do you think Youth4Health network members mentioned environment and health issues as their top concern in a recently conducted survey, and why did you become more involved in this area of activism?

Austėja Sakalauskaitė: I believe we're not talking enough about the direct impact of climate change on our health and its long-term prospects. It's a pressing issue that affects our physical and mental health and exacerbates global inequalities.

For example, think about the heat waves we have worldwide in the summer, which wasn't the case 10 or 20 years ago. Even for us as young people, it's getting hard to get outside and lead our everyday lives in this heat, not to mention the strain it puts on seniors and adults with existing health conditions.

Think about marginalized communities that are disproportionately affected compared to all others. We see people dying every day because they do not have access to clean water or because of the spread of communicable diseases, as mosquitoes are getting more active in those areas.

As part of the Youth4Health network, I want to increase understanding of how we want our health to be sustainable.

WHO/Europe: Based on what you hear from young people like yourself, are there any new health issues in your community that you think are linked to what is happening to the environment? We talk a lot right now about climate anxiety, for example.

Austėja: The mental health aspect of climate change stands out to me most. As young people, we don't get enough information about what is getting done regarding climate change, and we worry about our future and the future of the next generations. Many are dealing with mental health struggles as they are forced to move from the places where they were born and used to live because of rising sea levels or depleting natural resources. We do not know what our lives will look like even in 5 to 10 years. This needs to change.

WHO/Europe: How should we explain the urgency behind advocating for environment and health issues together?

Austėja: If we fail to mitigate the impact of climate change on health, we will see a lot of health problems emerging and resurfacing, which will inevitably affect our life expectancy and quality of life. Heat-related illnesses, infectious diseases, a spike in chronic lung conditions, such as asthma caused by worsened air quality, malnutrition - especially in areas where access to clean water and food is scarce - and a lack of resources in hospitals to treat such patients, to name a few.

I would urge world leaders to take bold actions within climate change negotiations and consider the health implications of climate change in the decision-making process to create a healthy world for all of us. They must understand how climate change directly impacts health outcomes because our future depends on the actions they take today to protect our planet and our people.

WHO/Europe: How do you overcome stereotypes about young people's lack of capacity to meaningfully contribute their knowledge and expertise?

Austėja: A lot of young people, including myself, have imposter syndrome: we know we have a valuable opinion, but very few listen to us because we are too young or don't have enough experience. We often hear that we don't know how the world works, but this is exactly what we're trying to change!

In this context, I'm reminding myself not to lose focus. That's why building communities of like-minded people, like the one we have in Youth4Health, is so important, where we can inspire and support each other. Joining such networks and organizations helps you see that you can bring new, valuable ideas that adults didn't even think of.

It starts with one person who believes in you, which in turn motivates you to achieve new heights. Yes, we will still have those days of helplessness, and we will still ask ourselves if our work actually makes a difference, but it does. We have to accept that things will not change in seconds, days, or months, but taking consistent small steps every day can spark bigger changes.

WHO/Europe: How can we ensure that young people are really heard and seen in international health forums and at all levels of health decision-making?

Austėja: It is essential to participate in conversations with them strategically and consistently, not just as a one-time event. This is why it is vital for us as young activists to have WHO support. When national governments see WHO endorse the Youth4Health network and youth-led initiatives and events, they listen to us and discover that we have much to offer.

WHO/Europe: What's your take on young people's role in bringing health topics to climate negotiations like COP29? How can this be done?

Austėja: COP29 is an amazing opportunity to push policy-makers to include health in climate negotiations. As youth, we have to be present at COP29, talk about connection between climate change and health, and represent not just youth voices but the voices of the future generations. We should be vocal and use social media advocacy to spread awareness about this topic and the challenges climate change creates for public health.

In addition, youth presence at COP29 is crucial because this is a platform to form coalitions with NGOs [nongovernmental organizations], health and climate experts, and activists passionate about this topic. As long as more people join our cause, our voice will be heard, and we can have a stronger impact on the results of these negotiations.

WHO/Europe: And how are you planning to use the Budapest Youth Declaration for your campaigning and advocacy?

Austėja: This is the document everyone can consult to understand young people's opinions on this topic. It is a young people's manifesto urging world leaders to prioritize health in climate change negotiations. It also lays out what we, as young people, commit to doing and what we expect from others.

The Declaration is very concise and precise. At COP29, we can definitely use it to highlight what young people want in climate policies and what concrete actions we should take to achieve a healthier and more sustainable future for us and future generations. This tool positions our youth organizations and networks as a force to be reckoned with.

WHO/Europe: Can you tell us more about the European Environment and Health Process (EHP) Partnership on Youth?

Austėja: This is our effort to involve young people in developing and implementing policies that address environment and health issues. As part of this mechanism, they collaborate with governments on concrete projects and raise youth organizations' profiles as credible partners.

In my view, the most important thing about the EHP Partnership on Youth is balance: in our rules, we encourage Member States from the WHO European Region to join together with youth organizations from their country, so that there isn't one side whose voice outweighs all others. To apply, Member States can send an email request to [email protected].

The EHP Partnership on Youth is very horizontal and enables youth to get involved in a variety of topics around climate and health. For example, members can choose a topic they want to work on together when they join, and our role is to facilitate this collaboration and youth involvement at all levels of such discussions.

WHO/Europe: And what kind of support do you think young people and youth organizations need to feel empowered to keep up their work? What do you think is required from governments and society at large on different levels?

Austėja: The main thing is just getting involved - if not in large-scale political debates, then even in the smallest events at the local level. Amplifying youth voices should become a whole-of-society priority as our impact increases with numbers.

Collaboration between organizations is key: in my home country, Lithuania, we set up youth groups to gather multiple perspectives on a specific topic across different youth coalitions and form a unified stance. Yes, we will not get everything just because there are so many of us and many aspects to consider, but at least we will get the bigger picture - a small change that makes a huge difference.

We still have to somehow push our opinion and ask to be invited to major events. We have already seen how governments and international organizations like WHO are starting to involve youth in discussions of policies or new research. But we certainly are eager to have more of them support our cause.

WHO/Europe: Are there any positive breakthroughs that give you hope and desire to keep up this great work

Austėja: Raising awareness about meaningful youth engagement at this interview is already a positive change. However, I'd also like to mention the community engagement component and increased cross-sectoral collaboration.

For example, I am currently part of the youth technical advisory board at the Sustainaware: Climate Action Going Digital project. We're creating an online escape room to help our peers understand how climate and health are interconnected through experiential learning. I'm giving something back to the community so that they can boost their knowledge while also making personal connections with people from different sectors. I hope that people who are now involved in [health] advocacy will continue in the future and become the new leaders of our world.

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